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Impact of dedicated pediatric neuro-oncological services in a developing country: A single-institution, Pakistani
Syed Ahmer Hamid1, Nida Zia1, Sidra Maqsood2
1Department of Pediatric Hematology and Oncology, Indus Hospital & Health Network, Karachi, Pakistan.
Insights
Establishing a dedicated pediatric neuro-oncology service significantly improved treatment and survival rates for children with brain tumors. This specialized care enhances patient outcomes and quality of life, even in resource-limited settings.
Area of Science:
- Pediatric Neuro-Oncology
- Central Nervous System (CNS) Tumors
- Oncology Management in Low- and Middle-Income Countries (LMICs)
Background:
- Pediatric brain tumors are a leading cause of mortality in children.
- Management of pediatric CNS tumors is complex and often deprioritized in LMICs.
- Dedicated neuro-oncology services are crucial for improving care standards.
Purpose of the Study:
- To evaluate the impact of a dedicated pediatric neuro-oncology service on patient outcomes.
- To compare treatment and survival rates before and after the service implementation.
- To assess changes in patient volume and treatment modalities.
Main Methods:
- Retrospective analysis of two patient cohorts: 1998-2013 (pre-service) and 2014-2019 (post-service).
- Comparison of treatment intent, survival rates, patient volume, and therapy use (chemotherapy, radiation).
- Evaluation focused on the introduction of a dedicated pediatric neuro-oncology service.
Main Results:
- Significant increase in patients treated with curative intent and improved survival rates post-service implementation.
- Patient volume increased from 15.5 to 44.8 patients per year.
- Increased utilization of radiation therapy, while chemotherapy use remained stable.
Conclusions:
- A dedicated multidisciplinary pediatric neuro-oncology team enhances treatment outcomes and supportive care.
- Specialized services improve the quality of life for children with brain neoplasms and their families.
- Implementation of such services is vital for improving pediatric brain tumor care globally.
Introduction:
Brain tumors are the most common solid neoplasms and the second most common malignancy in the pediatric age group. Due to the complexity of their management, pediatric central nervous system (CNS) tumors are not a priority in low- and middle-income countries (LMICs).
Methods:
In an attempt to improve the survival rate and overall care, we introduced a dedicated pediatric neuro-oncology service in our institute and evaluated its impact by dividing the pre- and post-era into two cohorts and comparing them: 1998-2013 (16 years: cohort A) and 2014-2019 (6 years: cohort B, after the start of dedicated neuro-oncology services).
Results:
We observed that after the implementation of a proper neuro-oncology service, the proportion of patients treated with curative intent increased, and survival improved in cohort B. The patient volume also increased from 15.5 per year in cohort A to 44.8 per year in cohort B. The percentage of children given radiation therapy also increased significantly, while the proportion of children treated with chemotherapy remained stable.
Conclusion:
A dedicated multidisciplinary team trained and knowledgeable in the specialty of pediatric neuro-oncology can enhance and improve outcomes, and supportive care and help can provide good quality of life to children and their families with brain neoplasms.
